Cal Poly Humboldt High School Scholars (HSS)

The High School Scholars (HSS) Program gives juniors and seniors in Humboldt and Del Norte Counties the opportunity to take college classes at Cal Poly Humboldt — on campus or online — and earn college credit while still in high school.

Provide your contact information, and the contact information for your parent/guardian and high school below. This form may be submitted by the student, or on behalf of the student. Upon receiving and reviewing your request, we will send you the High School Scholars Interest Form via AdobeSign.

If you encounter difficulties with this form due to disabilities or any other reason, assistance is available by phone at (707) 826-4402 and by emailing welcome@humboldt.edu.

Student Information

First Name (Student)

Preferred Name

Last Name (Student)

Student's Birthdate

Student's Email Address

Email Address Confirmation

Student's Mailing Address (optional)

Country

Street

City

Region

Postal Code

Student's Mobile Phone Number (optional)

Would you like to receive text messages?

Yes

High School Information

Current High School
You can start typing and select the school from the dropdown list.

High School Counselor, Principal or Designee's full name:

High School Counselor, Principal or Designee's email address:

University Information

Undergraduate Institution

Parent/Legal Guradian Information

Parent or Legal Guardian full name:

Parent or Legal Guardian email address:

Parent or Legal Guardian phone number: